لخّصلي

Sub-acute (Rehabilitation) Phase The rehabilitation needs of individuals with an SCI are best at a specialised Spinal Cord Injury Unit, but often rehabilitation begins in the Acute or Trauma Hospital while the individual is awaiting transfer to a Spinal Injuries Unit.Individuals with different levels of SCI perform different motor tasks differently and it's important for physiotherapists to understand which functions are obtainable relevant to the SCI level.[3][6] Objectives Treatment objectives of the rehabilitation phase include: o to establish an interdisciplinary process that is patient-focused, comprehensive and co-ordinated o to address physical motor functional activities with early intervention and management to prevent further complications o to improve an individual's independence in activities of daily living, such as bathing, eating, dressing, grooming, and mobility o to achieve functional independence, whether physical- or verbal equipment in order to facilitate this independence o to achieve and maintain successful reintegration into the community.[3][6] Physiotherapy is a key component during the rehabilitation process following spinal cord injury and includes a variety of interventions that address multiple domains in the International Classification of Functioning, Disability and Health (ICF) including body function and structure, activity limitation, and participation, with many interventions directed at preventing, rather than treating, impairments, activity limitation and participation restrictions.Vertical lifting for individuals with C6 tetraplegia can be possible by passively extending elbows, externally rotating shoulders and depressing shoulders to weight bear with hands placed anteriorly to the pelvis.Rehabilitation requires consideration of the whole person; their physical, psychological, vocational and social background.

Sub-acute (Rehabilitation) Phase
The rehabilitation needs of individuals with an SCI are best at a specialised Spinal Cord Injury Unit, but often rehabilitation begins in the Acute or Trauma Hospital while the individual is awaiting transfer to a Spinal Injuries Unit. Rehabilitation requires consideration of the whole person; their physical, psychological, vocational and social background. The rehabilitation process is a goal-directed, and time-limited process aimed at facilitating maximal independence and optimal reintegration back into the individual’s chosen community role and lifestyle. [3][6]
Physiotherapy is a key component during the rehabilitation process following spinal cord injury and includes a variety of interventions that address multiple domains in the International Classification of Functioning, Disability and Health (ICF) including body function and structure, activity limitation, and participation, with many interventions directed at preventing, rather than treating, impairments, activity limitation and participation restrictions. Quality of Life including community participation, gainful employment, interpersonal relationships, and leisure activities have become the overriding focus of management. [3][6]
Objectives
Treatment objectives of the rehabilitation phase include:
• to establish an interdisciplinary process that is patient-focused, comprehensive and co-ordinated
• to address physical motor functional activities with early intervention and management to prevent further complications
• to improve an individual’s independence in activities of daily living, such as bathing, eating, dressing, grooming, and mobility
• to achieve functional independence, whether physical- or verbal equipment in order to facilitate this independence
• to achieve and maintain successful reintegration into the community.
The range of therapy activities used by physiotherapists during rehabilitation varies depending on the level and type of injury. The three most common individual therapy activities for individuals with high-level tetraplegia were - range of movement/stretching, strengthening, and transfers; while for those with low tetraplegia, more time was spent on transfers than strengthening. Similarly, in individuals with paraplegia, the most common individual physiotherapy activities were transfers, followed by a range of movement/stretching, and strengthening.
Individuals with different levels of SCI perform different motor tasks differently and it's important for physiotherapists to understand which functions are obtainable relevant to the SCI level. All motor tasks should be divided into sub-tasks in order to perform activities optimally. In order to perform motor tasks successfully individuals should have sufficient strength, balance, ROM and knowledge or skill regarding the specific motor task. All these aspects can be achieved through frequent progressive training.
Bed Mobility and Transfers
C6 and lower level SCI have the ability to attain 5 motor skills; [1]
1 rolling (using momentum) -
2 mobilizing from supine to long-sitting
3 unsupported sitting (short- & long sitting)
4 lifting vertically
5 transfers
C6 tetraplegia may have some challenges, but these 5 motor skills are still possible with some modifications. With rolling, C6 tetraplegia should externally rotate shoulders and swing arms across their body instead of over-head. During an unsupported sitting, C6 tetraplegia should externally rotate shoulders and lock elbows in extension to maintain balance. Vertical lifting for individuals with C6 tetraplegia can be possible by passively extending elbows, externally rotating shoulders and depressing shoulders to weight bear with hands placed anteriorly to the pelvis.